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Mechanisms underlying the association between insomnia, anxiety, and depression in adolescence: Implications for behavioral sleep interventions

Blake, Matthew J., Trinder, John A., Allen, Nicholas B.·2018·Clinical Psychology Review
DOI 10.1016/j.cpr.2018.05.006
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Abstract

There is robust evidence of an association between insomnia, anxiety, and depression in adolescence. The aim of this review is to describe and synthesize potential mechanisms underlying this association and explore implications for the design of adolescent behavioral sleep interventions. Specifically, we examine whether insomnia symptoms are a mechanism for the development of internalizing symptoms in adolescence and whether sleep interventions are an effective treatment for both insomnia and internalizing symptoms in adolescence because they target the shared mechanisms underlying these disorders. Research using different methodologies points to the role of sequential, parallel, and interacting mechanisms. In this paper, we review a wide range of relevant biological (i.e., polymorphisms and dysregulation in serotonin, dopamine, and circadian clock genes; alterations in corticolimbic and mesolimbic brain circuits; cortisol reactivity to stress; inflammatory cytokine dysregulation; biased memory consolidation; changes in sleep architecture), psychological (i.e., cognitive inflexibility, interpretational biases, judgment biases, negative attribution styles, worry, rumination, biased attention to threat, dysfunctional beliefs and attitudes about sleep, misperception of sleep deficit), and social mechanisms (i.e., reduced and impaired social interactions, unhelpful parenting behaviors, family stress) and propose an integrative multilevel model of how these phenomena may interact to increase vulnerability to both insomnia and internalizing disorders. Several 'biopsychosocial' mechanisms hold promise as viable treatment targets for adolescent behavioral sleep interventions, which may reduce both insomnia and internalizing symptoms.

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Cited by

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Metadata

Authors
Blake, M. J., Trinder, J. A., & Allen, N. B.
Venue
Clinical Psychology Review
Publisher
Elsevier BV
Published
2018-07
Volume
63
Pages
25-40
ISSN
0272-7358 (ISSN-L)
DOI
10.1016/j.cpr.2018.05.006
OpenAlex
W2807614514
Cited by
443
References
88
FWCI
31.78
Type
journal article
Language
en
Open access
closed
Licence
  • www.elsevier.com/tdm/userlicense/1.0/ (tdm)
  • www.elsevier.com/legal/tdmrep-license (tdm)

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CoChat. (2026). Citation check: Mechanisms underlying the association between insomnia, anxiety, and depression in adolescence: Implications for behavioral sleep interventions. https://app.cochat.ai/papers/10.1016/j.cpr.2018.05.006
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Blake, M. J., Trinder, J. A., & Allen, N. B. (2018). Mechanisms underlying the association between insomnia, anxiety, and depression in adolescence: Implications for behavioral sleep interventions. Clinical Psychology Review. https://doi.org/10.1016/j.cpr.2018.05.006

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